Bronchobiliary fistula after hemihepatectomy: cholangiopancreaticography, computed tomography and magnetic resonance cholangiography findings

A bronchobiliary fistula (BBF), which is defined by an abnormal communicati on between the biliary system and the bronchial tree, is an uncommon compli cation after hemihepatectomy, trauma, hydatid disease, choledocholithiasis and other causes of biliary obstruction. We report the case of a 56-year-ol d man with colon cancer. who developed a BBF 2 months after right hemihepat ectomy for liver metastases. The findings at endoscopic retrograde cholangi opancreaticography (ERCP), computed tomography (CT) and magnetic resonance cholangiography (MRC) included a stricture of the common bile duct and bili ary leakage from the liver resection plane with biliary infiltration of the right lower lobe of the lung. The patient was treated successfully by endo scopic insertion of a biliary plastic stent which bridged the stricture and lead to closure of the fistula. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.